Comparative Efficacy of Antiallergics and Quality of Life in Patients with Allergic Rhinitis

Abstract

Background: Allergic rhinitis can substantially affect patients’ health-related quality of life, as its impact extends beyond nasal complaints to include symptoms such as headache and fatigue. Assessment of allergic rhinitis in clinical research has traditionally focused on symptom severity, nasal airflow, and findings from nasal cytological examination. Evaluating clinical outcomes should therefore extend beyond the control of physical symptoms to include improvements in daily functioning and overall well-being. In this context, the present study was designed to evaluate and compare the therapeutic effectiveness and safety profiles of three antihistamine agents (cetirizine, loratadine, and astemizole) in patients with allergic rhinitis and their effect on health-related quality of life.

Material and Methods: A prospective cohort study was conducted at the outpatient department of the Ear, Nose, and Throat (ENT) unit at a tertiary care hospital of Karachi, from November 2022 to May 2023. Eligible participants were then randomly assigned to one of three treatment groups, with 30 patients allocated to each group according to the medication prescribed: Group I: Cetirizine 10 mg orally once daily, Group II: Loratadine 10 mg orally once daily, Group III: Astemizole 10 mg orally once daily. Medication supplies and recording cards were renewed during weekly follow-up visits throughout the six-week study period. The perceived improvement in symptoms was assessed using a visual analogue scale (VAS) ranging from 0 to 10. Data was analyzed by using Statistical Package for Social Science (SPSS) version-22.

Results: The reduction in symptoms was statistically significant in all three groups. Cetirizine provided greater relief from sneezing than loratadine (p<0.05). Loratadine showed better control of sneezing than astemizole (p<0.05). A greater reduction in nasal obstruction was observed among patients receiving cetirizine compared with those treated with loratadine and astemizole, with the differences being statistically significant (p<0.05). In terms of ocular symptoms, significant differences were observed in comparisons between the cetirizine and astemizole groups and between the loratadine and astemizole groups. Although this adverse effect was reported in each group, it was most pronounced among patients receiving cetirizine, followed by astemizole and loratadine.

Conclusion: The findings of this study indicate that all three antihistamines, cetirizine, loratadine, and astemizole, were generally well tolerated, with relatively few adverse effects reported during treatment. However, cetirizine showed better overall symptom control than loratadine and astemizole, providing greater relief from the symptoms of allergic rhinitis.

Keywords: Allergic rhinitis, Cetirizine, Loratidine, Astemizole